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HLSC 222 - Midterterm 2 > Gastro - class 2 - accessory organs > Flashcards

Gastro - class 2 - accessory organs Flashcards

1
Q

Sings and symptoms of acute pancreatitis? What are they caused by?

A

constant mild to severe epigastric pain may radiate to the back

Caused by edema, chemical irritation, obstruction of biliary tract, and inflammation of nerves

Fever, increased WBC count, nausea & vomiting, and jaundice

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2
Q

What strains of hepatitis might not become jaundiced? What can they become?

A

Chronic B, C, & D may not become jaundiced and may not be diagnosed – can become carriers – carrier mothers can transmit to infants through the placenta

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3
Q

Risk factors for colorectal cancer?

A

1.) *Polyps

2.) Long term inflammatory bowel disease

3.) Diverticulites

4.) Highly refined carbohydrates - low fibre high fat diets

5.) Strong genetic connection – family history of colorectal cancer puts you at greater risk

6.) Any repeated trauma to the colin

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4
Q

What is happening pathophysiologically in the GI tract in children that have cystic fibrosis?

A

Dysfunction of cystic fibrosis protein located in epithelial membranes – regulates chloride and sodium ion channels

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5
Q

Prevention technique for diarrhea in children?

A

– clean water and proper hygiene

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6
Q

What strains of hepatitis are contagious?

A

B, C, D

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7
Q

Risk factors for hernias in children?

A

Prematurity
Genetics
Undescended testes

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8
Q

What causes a cleft lip and plate?

A

Caused by the incomplete fusion during the second month of development – both genetic and environment – imedate problems with feeding –

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9
Q

What kind of cancer cells are in pancreatic cancer?

A

Adrenocarcinoma

(Exocrine part of gland, ductal epithelium)

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10
Q

Patho process for intussusception?

A

1.) Ileum telescopes into the cecum and part of ascending colon through the ileocecal valve

2.) Venous stasis occurs within hours due to the compression of the mesentery vessels between two layers of intestinal wall

3.) Can lead to ischemia and necrosis if not treated

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11
Q

What kind of cancer cells are in Liver cancer?

A

Hepatomas
Cholangiomas

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12
Q

What is a Triad?

A
  • Involved with cystic fibrosis

It is a obstruction, infection, & inflammation throughout the GI tract in children and within the airways, which alters resorption of sodium, chloride, & potassium

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13
Q

Manifestations of esophageal cancer?

A

-Chest pain
-Dysphagia

  • Most common type of pain is heart burn
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14
Q

Signs and symptoms for chronic pancreatitis?

A

– intermittent or continuous abdominal pain & weight loss

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15
Q

What are the GI presentations/issues for children with cystic fibrosis?

A

Nutrients aren’t being digested properly

Wil have multiple complications, obstruction, and imfalamtion in their GI tract

Culture their own bacteria that’s in their GI + resp tract

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16
Q

How do we treat intussusception in the large and small bowel?

A

Large bowel intussusception may correct itself with an enema

Small bowel requires laparotomy

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17
Q

What is the most common cause of portal hypertension?

A

Fibrosis and obstruction caused by cirrhosis of the liver

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18
Q

Sings and symptoms of pyloric stenosis?

A

-Occurs at 2-8 weeks after birth

-Forceful, nonbilious vomiting immediately after feeding – projectile vomiting

-Needs to be refed – this causes a failure to thrive

-Constipation due to no fluid reaching the intestines

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19
Q

Risk factors for pancreatitis?

A

Risk factor cholelithiasis, alcoholism, obesity, peptic ulcers, trauma, dyslipidemia, hypercalcemia, smoking, some meds, and genetics

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20
Q

What is Cirrhosis?

A

It is an irreversible inflammatory and fibrotic liver disease - widespread damage to cells in our liver

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21
Q

What do we look for with colorectal cancer?

A

Inflammation and polyps

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22
Q

Sings and symptoms of jaundice?

A

bilirubin appears in urine (dark amber), before seen in skin

grey or light coloured stools in complete obstruction

fever, chills, pain, and itchy skin

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23
Q

Sings and symptoms for pancreatic cancer?

A

-early stages asymptomatic, the symptoms come with malignancy

-Vague upper abdominal pain radiates to back

-Jaundice due to obstruction of bile duct

-Weight loss due to impaired enzyme secretion which leads to fat and protein malabsorption

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24
Q

What is alcoholic liver disease?

A

Alcoholic liver disease:
-greatest in middle aged men but women will develop more severe injury than men – when women develop it = causes more damage

-most prevalent of cirrhosis

-not all alcoholics will develop cirrhosis of the liver 25%

Can also be caused by malnutrition

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25
Q

Stages of pancreatic cancer?

A

Stages – we start with smaller then bigger – we can’t remove the pancreas

0 – cancer in situ – top layers of pancreatic duct cells
1 – confined to pancreas <2 cm or < 4 cm
2 – confined to pancreas > 4 cm
2B – > 2 cm or >4 cm spread to no more than 3 lymph nodes
3 – size dependent for a,b,c + spread to 4 or more lymph nodes OR grown outside of the pancreas with no lymph nodes involved
4 – spread to distant sites – any size, may or may not have lymph node involvement

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26
Q

What kinds of nodes can we have with liver cancer?

A

Can have several small nodes or a single centeral node with smaller ones

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27
Q

What are the 4 stages of liver cancer? Survival is dependant on?

A

1 - One section involved; three adjoining sections are tumor free.
2 - One or two sections involved; two adjoining sections are tumor free.
3 - Two or three sections involved; one adjoining section is tumor free
4 - Four sections involved.

Survival rate dependent on stage of tumour

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28
Q

How are gallstones formed?

A

stones formed from impaired metabolism of cholesterol, bilirubin and bile acids they form in bile that is supersaturated with cholesterol which sets up cholesterol crystal formation over time more crystals aggregate and increase in size

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29
Q

Causes of failure to thrive?

A

multifactorial condition – biological, psychosocial, and environmental contributions

80% will have no underlying medical condition

Inadequate intake

Inadequate absorption

Excessive caloric expenditure

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30
Q

How do we stage liver cancer?

A

When we stage liver cancer, it is stage where it is located on the liver

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31
Q

What is tumor initiation in colorectal cancer?

A

-First stage of tumour growth

-Starts with an adenomatous polyps which moves to carcinoma that may take 8-10 years to progress

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32
Q

What is lactose intolerance in children caused by?

A

Caused by inadequate production or impaired activity of the enzyme lactase

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33
Q

What is diarrhea in children? What can it be?

A

Increase of water content, volume, or frequency of stools

Life treating- leading cause of death in children

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34
Q

Cause of pyloric stenosis

A

Unknown cause – could be multifactorial with genetic and environmental factors

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35
Q

What is failure to thrive?

A

Physical sign that a child is receiving inadequate nutrition for optimal growth and development
Deceleration in weight gain,

Usually presents before 18 months

Doesn’t always have a cause

Diagnosed when the constantly loose weight

Can be from poor nutrition/feeding or happens on its own

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36
Q

What is jaundice?

A

Jaundice – yellow pigmentation of the skin caused by hyperbilirubinemia

-bile duct is occluded by gallstones, tumours, or inflammation

-hemolytic jaundice is caused by excessive hemolysis
Darker stool
Getting rid of bulirubnemia

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37
Q

Signs and symptoms of Hirschsprung disease?

A

-Colicky abdominal pain
Irritability, knees drawn to chest

-Abdominal mass

-Vomiting and bloody stools

-More acute obstruction – increase tenderness and distension

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38
Q

How is hepatic encephalopathy characterized?

A

characterized by impaired behavioral, cognitive, and motor function – can develop quickly in hepatitis or slowly in cirrhosis

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39
Q

How long can chronic and acute diarrhea last for in children?

A

Acute – can remain mildly symptomatic for 4 weeks

Chronic – longer than 4 weeks

40
Q

What can the inflammatory process of hepatitis damage? What strains have the most severe damage?

A

Inflammatory process of hepatitis can damage and obstruct bile capillaries, leading to bile obstruction and obstructive jaundice

Damage most severe in Hepatitis B & C

41
Q

Sings and symptoms of liver cancer?

A

-Pain
-Anorexia
-Bloating
-Weight loss
-Portal hypertension
-Ascites
-Jaundice

42
Q

What happens with lactose intolerance in children? (diarrhea slides)

A

Lactose intolerance – lactose malabsorption and lactose intolerance
Inability to digest milk and sugar

43
Q

What is portal hypertension? What is it caused by?

A

(slides)Portal hypertension – high blood pressure in the portal venous system – main issue that’s going on – portal vein is getting backed up – causes esopageial varieses and have a back up going into the spleen

Portal hypertension is abnormally high blood pressure in the portal venous system caused by a resistance to blood flow

44
Q

What are the consequences of cirrhosis?

A

1.) Portal hypertension

2.) Ascites

3.) Jaundice

45
Q

Risk factors for pancreatic cancer?

A

smoking, high-fat foods, processed meat, obesity, diabetes mellites, chronic pancreatitis, family history

46
Q

What is hepatocellular carcinoma? What are the different kinds?

A

develops in the hepatocytes – the main functioning cells of the liver - liver cancer

Can be:
Nodular – multiple discrete nodules
Massive – large tumour mass with several satellite nodules
Diffuse – small nodules distributed throughout the liver

47
Q

What is Splenomegaly? What does it manifest as?

A

spleen becomes enlarged due to increased pressure in splenic vein.

Manifests with thrombocytopenia.

48
Q

What are the 3 different types of gallstones? What are they associated with?

A

1.) Cholesterol (associated with 70-80% cholesterol)

2.) Black (rare, associated with chronic liver disease and hemolytic disease)

3.) Brown (associated with biliary stasis, bacterial infections, biliary parasites)

Can also have a combination of above

49
Q

Patho process for pyloric stenosis

A

1.) Muscle fibers thicken so the pyloric sphincter becomes enlarged and inflexible

2.) Extra effort to force gastric contents may cause muscle layers of stomach so they become hypertrophied as well
Band around the sphincter is to tight and causes vomit

50
Q

What are the stages of colon cancer?

A

▪ Stage 0:
* Carcinoma in situ
*cancer cells are only in the inner lining of the colon or rectum (Mucosa)

▪ Stage 1
* Through to muscle layer
-tumour has grown into the layer of connective tissue that surrounds the mucosa (submucosa

▪ Stage 2
* Involves serosa
-into tissues beyond the muscle layer into other organs

▪ Stage 3
* Lymph nodes involved
▪ cancer cells in lymph nodes near the colon or rectum

▪Stage 4
* Metastasis
-cancer has spread to other parts of the body (called distant metastasis), such as to the liver or lungs

51
Q

What are the 3 stages of alcoholic liver disease?

A

1.) Steatosis –
Fat deposition in the liver – lipids from adipose tissue or dietary intake contribute to fat accumulation
-Can be caused be low volumes of alcohol

*At this stage it is reversible if patient stops drinking

2.) Fibrosis –
-Increased hepatic storage of fat
-Inflammation and degeneration leads to necrosis of hepatocytes
-Stimulates irreversible fibrous characteristics
-Harding

3.) Cirrhosis –
-Caused by chronic alcoholism and malnutrition
-Cell damage initiates an inflammatory response that results in excessive collagen formation
-Fibrosis and scarring alter the structure of the liver which obstructs biliary and vascular channels

Irreversible

52
Q

What is Hepatocellular carcinoma with liver cancer? Signs and symptoms?

A

is asymptomatic at the beginning can develop symptoms slowly or abruptly

Nausea & vomiting, fullness, pressure, dull ache in RUQ, sudden worsening of portal hypertension, ascites if there is an obstruction

53
Q

What is Hepatic encephalopathy?

A

It is a decline in brain function that occurs as a result of severeliverdisease

-Complex neurological syndrome that is characterized by impaired behavioural, cognitive, and motor function

54
Q

What are hernias caused by in children?

A

Caused by weakness in abdominal muscle

55
Q

If left untreated what happens with pyloric stenosis?

A

leads to severe fluid and electrolyte imbalances, malnutrition, and weight loss than can be fatal in 4-6 weeks

56
Q

Sings and symptoms of a triad?

A

Partial intestinal obstruction – severe cramping pain

Absence of pancreatic enzymes – malabsorption of food leads to fatty, bulky stools

Decreased vitamin absorption – glucose intolerance, fatty liver

57
Q

In Ascites what is there a decrease in synthesis of? What will it cause?

A

Decreased synthesis of albumin in liver with portal hypertension will cause capillary hydrostatic pressure to exceed capillary osmotic pressure pushing water into the peritoneal cavity

58
Q

What are the two kinds of cancer cells in cancer of the esophagus?

A

Squamous cell carcinoma and adenocarcinoma

59
Q

Why is stomach cancer on the decline?

A

Incidence of stomach cancer has been on a steady decline – due to improvement of diets, decreasing smoking & alcohol use, recognition and treatment of the H.Pylori bacteria

60
Q

What is Cholecystitis? What do we do if it is chronic?

A

Inflammation of the gallbladder

-Chronic - we surgically remove it

61
Q

Galstones risk factors?

A

Risk factors – obesity, middle age, female gender, use of oral contraceptives, rapid weight loss, First nation ancestry, genetics, disease of gallbladder, pancreatic, or ileal (small intestine)

62
Q

Manifestations of colorectal cancer?

A

-Pain
-Mass
-Edema
-Bloody stool
-Obstruction
-Distension

63
Q

What is Ascites?

A

-Complication of liver disease

-It is abnormal buildup of fluid in the abdomen trapped fluid in peritoneal space

64
Q

Risk facts for stomach cancer?

A

-Salty food
-Fried red meet
-Nitrates- nitrosamines

65
Q

Where does Ascites come from?

A

-Comes from portal hypertention – fluid gets pushed out into interstial space

66
Q

Hernias are most common in what age group?

A

Herniascan occur at any age but are most common in newborns but may not be noticeable for several weeks or months after birth.

67
Q

What do we see/what is the main cause of hepatic encephalopathy?

A

See a deteriation of brain function because the ammonia is not being properly removed

Toxins normally removed by the liver eventually travel to the brain

68
Q

What are Varices?

A

-Relates to portal hypertension

-an abnormally dilated vessel usually located in the lower esophagus and stomach

-Rupture can be life threatening

69
Q

What are the 3 stages of hepatitis?

A

1.) Prodromal phase – 2 weeks after exposure, ends with appearance of jaundice – fatigue, anorexia, malaise, nausea, vomiting, headache, cough, low grade fever

2.) Icteric phase – 1-2 weeks after prodromal - lasts 2-6 weeks - jaundice, dark urine, clay stools, liver is enlarged, tender, any assessment of liver causes pain –

3.) Recovery phase – resolution of jaundice, liver remains enlarged and tender, return of normal liver function 2-12 week after jaundice

70
Q

Risk factors for cleft lip and palate?

A

Maternal alcohol and tobacco use, maternal diabetes mellitus, folate deficiency

71
Q

What is pyloric stenosis? What is it a common cause of?

A

It is the narrowing & distal obstruction of the pylorus

It is an acquired narrowing and distal obstruction of the pylorus and a common cause of postprandial vomiting

72
Q

Signs and symptoms of gallstones?

A

Can be asymptomatic

Epigastric & right upper quadrant pain

Intolerance for fatty food manifests as heartburn, flatulence, epigastric discomfort and food intolerances

73
Q

What are the two kinds of polyps?

A

Hyperplastic – benign growth – projection arising from mucosal epithelium

Neoplastic - adenomatous polyps – premalignant lesions

Larger the polyp the greater the risk

74
Q

Causes of Ascities?

A

Biggest cause is cirrhosis, but can also be caused by heart failure, abdominal malignancies, nephrotic syndrome (pass too much protein in urine), and malnutrition

Third spacing of fluid into the parnetial space
Massive amounts of fluid going into the abdomen

75
Q

What is chronic pancreatitis? What is the most common cause? Where may it also come from?

A

progressive fibrotic destruction of pancreas

Chronic alcohol abuse is most common cause

May also come from gallstones, smoking, genetics

-We have to manage the pain at this level/stage

76
Q

What is Intussusception? What is it the most common cause of?

A

Telescoping of proximal segment of intestine into a distal segment – causing obstruction -

Most common cause of SMALL bowel obstruction in children

Most occur between 5 & 7 months of age

77
Q

Signs and symptoms of Hirschsprung disease?

A

-Symptomatic in first 24-72 hours after birth

-Delayed passage of meconium

-Mild to moderate constipation

-Poor feeding, poor weight gain

-Increasing distention

-Watery diarrhea as water may pass obstruction

78
Q

What is Hirschsprung disease?

A

It is a functional obstruction of the colon - it is the most common cause of colon obstruction, accounting for about 1/3 of all GI obstructions in infants

79
Q

Why is diarrhea in children dangerous?

A

Because Children have lower fluid reserves than adults

They need to be monitored closely for dehydration if they have diarrhea

80
Q

What is acute pancreatitis?

A

Obstruction of the outflow of pancreatic digestive enzymes – bile and pancreatic duct obstruction

Can also result from alcohol, medications, or viral infection

-Having an attack, sharp (knife) pain

-Comes from our alcoholics

-We rest our patients to give the relief

81
Q

Manifestations of stomach cancer?

A

-Anorexia
-Malaise
-Weight loss
-Upper abdominal pain
-Vomiting
-Occult bleeding

82
Q

What does Hepatocellular carcinoma invade?

A

Invades portal and hepatic veins so it quickly spreads to heart and lung

83
Q

What happens to the pancreatic ducts in a triad?

A

Pancreatic ducts are blocked by mucus causes malabsorption and fibrotic changes in pancreas

84
Q

What kinds of cancer cells in colorectal cancer?

A

Adrenocarcinoma

(left colon grows as ring - right colon grows as a man)

85
Q

What is the route of transmission for viral hepatitis?

A

A.) Fecal oral route
B.) Blood and other body fluids
c.) Blood
D.) Blood and other body fluids
E.) Fecal oral route - ONLY this one

86
Q

What kind of cancer cells are in stomach cancer?

A

Squamous cell carcinoma and adenocarcinoma

87
Q

How do cleft lips and palates present?

A

Presents with facial deformity and Difficulty with feeding – can’t generate negative pressure in sucking – may not be able to swallow normally – will put tube feed down until able to eat if needed

88
Q

Risk factors for esophageal cancer?

A

malnutrition, alcohol, tobacco

89
Q

Sings and symptoms of a hernia in children?

A

Bulge in the groin or scrotum

Typically come and go

May get bigger if childis straining or crying. Crying or straining doesn’t cause hernia it just makes them easier to see.

90
Q

Signs and symptoms for hepatitis?

A

– range from being asymptomatic to full liver failure and coma

91
Q

What does the enlarged spleen hold onto in splenomegaly? What can it cause?

A

The enlarged spleen holds too many platelets – Holds onto our white blood cells and can cause us to go into a thrombothetia state

92
Q

Causes of Hirschsprung disease?

A

Cause:
1.) Absence of nerve cells in part of colon – rarely is it the entire colon

2.) Causes decreased peristalsis and distention to proximal colon

3.) Develops ‘megacolon’

93
Q

What is Cholelthiasis?

A

Gall stones

94
Q

What are the 3 different kinds/causes of portal hypertension?

A

Pre-hepatic - Any disease that obstructs or impedes blood flow

Hepatic - Cirrhosis of the liver or viral hepatitis that cause inflammation or fibrosis

Post-hepatic - Cardiac disorders that impair pumping ability of the right side of the heart

95
Q

Sings and symptoms of failure to thrive?

A

Feeding problems, delayed growth, dry skin, sparse hair, poorly developed musculature, decreased subcutaneous fat

96
Q

What is the most common sign of portal hypertension? What is it caused by?

A

Hematemesis is the most common sign of portal hypertension due to esophageal varices rupture

As it is caused by liver disfunction can also have a history of jaundice and hepatitis, alcoholism, or cirrhosis

HLSC 222 - Midterterm 2 (9 decks)

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